ADHD Medication Chart

Methylphenidate Based 

MedicationFormDose/ScheduleDose RangeOnset/DurationMost Common
Side Effects
ProPrecautions
Methylphenidate
(MPH)
Ritalin
Methylin
tablets IR
5, 10, 20 mg
chewable IR
2.5, 5, 10 mg
liquid IR
5 mg/5ml
10 mg/5ml
Usually given two or three times a day.
Begin 5 mg early AM & noon.
Child:
5-45 mg
Adoles:
10-60mg
Adults:
20-80mg
onset: 15-20 min
duration:4 hrs max
Decreased appetite, decreased sleep, less
common: headaches, stomach aches, irritability, weight loss, tics,
“rebound”.  Can overstimulate or make too calm if dose is
too strong. These are true for all stimulants listed on the
first two charts
Same as above.
EVERY MEDICINE ON
THIS TABLE IS (MPH) METHYLPHENIDATE BASED
Methylphenidate is the generic name of
all these. Works quickly, effective often. The most studied. Little to no lab
testing needed. Good safety history. Methylin has no dye, is very small,
and comes in grape chewable and liquid.
Focalin is a refined isomer form which may be better tolerated and
smoother.
Caution if history of tics or Tourette’s
or high blood pressure or heart problems. Controlled substance. Must hand write all scripts,
no refills, no call ins.  True for all stimulants listed on the first
two charts
Some kids get “meaner” with stimulants, especially amphetamines
listed on second chart.

Focalin (dexmethylphenidate)
Focalin XR

tablets IR
2.5, 5, 10mg
Focalin XR comes in 5, 10, 15, 20, 25, 30, 35, 40mg
Focalin: 4-5 hrs.

Foclin XR: 8 hrs.

methylphenidate-SR

Ritalin-SR

Methylin ER

Metadate ER

tablets
10mg  SR
20mg  SR
10mg ER
20mg ER
Begin 10 or 20mg SR in AM, may need
increase or noon dose. May need regular Ritalin to start in AM or extend
duration to PM.  All 4 of these are time release capsules.
Child:
10-40 mg
Adoles:
20-40 mg
Adults:
20-80 mg
onset: 30-60 min
duration: 5-8hrs
These
are longer lasting versions of methylphenidate. Avoids noon dose, usually.
Concerta is a methylphenidate in a clever osmotic pressure release
mechanism pill. Metadate CD uses a third mechanism to extend the duration
and smooth the effect of methylphenidate. Metadate CD,  Ritalin LA,
Aptensio XR, and Focalin XR  capsules can be pulled apart and
sprinkled on food. Quillivant is a time release liquid while Quillichew
is  a chewable time release pill.  Daytrana is a skin patch.
Metadate CD is 30% IR + 70% ER
Ritalin LA is 50% IR + 50% ER

Concerta ER

18, 27, 36, 54mg
Once a day in
AM.
Child: 18-27mg
Adoles: 27-54mg
Adult: 36-72mg
onset: 15-30 min
duration: 8-10 hrs.

Metadate CD
Ritalin LA
10, 20, 30, 40,
50, 60mg CD capsule
10, 20, 30, 40mg capsules
These 2 are time
release capsules.
Start 10-20mg AM
Give once a day in AM
Max is 60mg/d
Child: 10-40mg
Adoles: 20-40mg
Adult: 20-60mg

onset: 30 min.
duration: 6-8 hrs.

Quillivant XR
Quillichew ER

Liquid suspension
25mg/5ml
(5mg/1ml)
Chewable tablets
10, 20mg scored
40mg is not scored
 

Once a day in AM
10-20 mg start


10mg/d = 2 ml
20mg/d = 4 ml30mg/d = 6 ml40mg/d = 8 ml50mg/d = 10 ml
Child: 10-40mg
Adoles: 10-60mg
Adult: 10-60mg
onset: 30 min
duration: 8-12 hrs.
onset: 30-60 min
duration: 8-12 hours
 

Same as above.

The only time
release liquid stimulant.
The only
chewable extended release ADHD med.
Releases biphasic 30% IR + 70% ER

Comes as powder in bottle, add water, shake vigorously before each use. Refrigerate. Use dropper to measure.
Brand only – 2014New formulation
2016
Brand only
Aptensio XRcapsule 10, 15,
20, 30, 40, 50, 60mg
Once a day in AM
Start 10 mg
Child: 10-40mg
Adoles: 10-60mg
Adult: 10-60mg
onset: 30-45 min
duration: 8-12 hours
Same as above.Another capsule
option. Can be sprinkled on food. 40% immediate (IR) and 60% delayed
release.

DAYTRANA
(methylphenidate
transdermal system)

patch
10, 15, 20, or 30 mg/9 hours

One patch per day to hip in early a.m. Remove after 6 to 12 hours – 9 hours is advised.

Child: 10-20mg
patchAdoles: 15-30mgpatchAdult: 15-30mg

onset: 2 hours
duration: 1-2 hours after patch removed
Same as above plus patch may irritate skin.

 

Although not
designed to be cut, patch can be cut to lessen dosage.
Avoids oral dosing. Should cover school day and longer. Duration can be adjusted by time patch is put and removed. May be smoother.
Patch can be removed early to shorten duration.

Slow onset.
Patch may come off accidentally.
Patch may rarely lastingly discolor skin. Even low dose patch may be too
strong for a child.
Brand only.

Simultaneous use of alcohol or cigarettes and especially street drugs should be avoided. All medications should be avoided if possible in pregnancy. This chart is intended to be a summary guide, not a full and complete list.

Amphetamine Based

MedicationFormDose/ScheduleDose RangeOnset/DurationMost Common
Side Effects
ProPrecautions
DEXEDRINE
(dextroamphetamine)
tablet (scored)
IR
5mg
10mg
Same as RitalinChild: 2.5-30 mg
Adoles:10-45 mg
Adults:10-60 mg
onset: 30 min
duration: 4-5 hrs
Same as Ritalin
(MPH) – see 1st chart
Stronger and longer effect than
Ritalin (MPH).
Some people do better with amphetamines. Generic available.
Avoids noon dose, usually. Generic available.IR Usually once or twice a day. Two doses
usually cover a whole day. The XR form should cover the whole school day
but may require an after-school IR boost. The XR capsule can be opened and
sprinkled on food. Generics are available. Adderall is the most abused
stimulant.
25% L and 75% D – amphetamines
Stimulants, especially amphetamines, can help narcolepsy.
Precautions
same as Ritalin (MPH) but more so regarding growth, heart, blood pressure,
tics, speedy, agitation, anger and abuse.
Inappropriately, I believe, all amphetamines are FDA approved down to age
3, while milder MPH is only approved down to age 6.Adderall is combination of two types of
dextroamphetamine and two types of amphetamine.
Adderall is the most abused.  Adzenys and Evekeo have similar
potential as they are also combinations of both amphetamine and
dextroamphetamine.Approved use as diet or binge eating treaments is questionable to me.
DEXEDRINE – SRspansules SR
5mg
10mg
15mg
Begin 5mg in early AM. May only need once
a day. May need regular Dexedrine in AM to start effect early, or
afternoon dose to extend effect in afternoon.
Child:5-15 mg
Adoles:
10-30 mg
Adult:
10-40 mg
onset: 30-60 min
duration: 6-8 hrs
Same as MPH –
see 1st chart
Less rebound in longer lasting medicines.
ADDERALL
dextroamphetamine and
amphetamine
ADDERALL-XR
tablet (scored)
5, 7.5, 10, 12.5, 15, 20, 30mg IR
capsules 5, 10, 15 20, 25, 30mg XR
1 or 2 times a day.
XR may be once a day.
Child: 5-30 mg
XR 10-20mg
Adoles:
10-40 mg
XR 10-30mg
Adults:
10-50 mg
XR 10-30mg
IR onset: 30 min
duration: 4-6 hrs
XR onset: 30-60 min
duration: 8-10 hrs
Similar to MPH.
– see 1st chart
EVEKEO
D and L amphetamine sulfate
tablet (scored)
5, 10mg IR
once to twice or
rarely 3 times a day
Child: 2.5 – 20mg
Adoles: 5-30mg
Adult: 5-40mg
onset: 30 min.
duration: 4-6 hrs
Similar to MPH – see 1st chart



Same as Adderall IR
Very similar to
Adderall IR tablets.
Is a 50/50 racemic mix of L and D amphetamine.
New in 2016.  Brand
ADZENYS XR ODT
orally disintegrating tablet
D and L amphetamine
tablet: 3.1, 6.3,
9.4, 12.5, 15.7, 18.8mg XR
Once a day in AM
Start 3.1 to 6.3 based on age and weight.
Child: 3.1 – 9.4
Adoles:3.1 – 18.8
Adult: 3.1 – 18.8
onset: 30-60 min
duration: up to 12 hours
Similar to MPH –
see 1st chart
Same as Adderall XR
This is
equivalent to Adderall XR and is the only orally disintegrating ADHD med.
New 2016. Brand
DYANAVEL XR
oral suspension
D and L amphetamine
liquid suspension
2.5 mg/ml
(1 ml = 1 cc)
Once a day in AM
Start 2.5 mg
Max 20 mg
Child: 2.5-10mg
Adoles: up to 20mg
Adult: up to 20mg
onset: 30-60 min
duration: up to 12 hours
Similar to MPH –
see 1st chart
Same as Adderall XR
This is simply
an Adderall like mixed amphetamine XR option in a liquid form.
Does not need refrigeration.  Comes ready mixed, shake before using.
New 2016. Brand
VYVANSE
(lisdexamfetamine)
capsule
10, 20, 30, 40, 50, 60, 70 mg XR
Once a day in AMChild: 10-50mg
Adoles: 20-70mg
Adult: 20-70mg
onset: 30-45 min
duration: 8-12 hrs
Similar to MPH –
see 1st chart
Longer duration. Capsule can be opened
and sprinkled on food. Pro – drug avoids IV and snorting routes of abuse.
Brand only.  May be gentlest amphetamine.

Non-Stimulants

MedicationFormDose/ ScheduleDose RangeOnset/ DurationMost Common Side EffectsProPrecautions
Strattera
(atomoxetine)
capsules
10, 18, 25,40, 60, 80, 100mg
Once or twice daily. Start in AM. Give
evening if sedation.
Based on weight, 0.5 to 1.5mg/kg, target
1-1.4 mg/kg
onset 30-60 min
duration: 5-8 hrs,
steady state
Stimulant side effects but milder (see
Ritalin); plus sedation, nausea possible.
Increases norepinephrine (NRI)
stimulant-like action but lasts all day. Not a controlled substance. No
direct dopamine effect so may be better tolerated.
Takes 2 to 4 weeks for maximum effects.
Must be taken 7 days a week. Only available as brand.
Tenex
(guanfacine)
Intuniv
(guanfacine ER)
tablets
1.0 mg
2.0 mg
tablets
1, 2, 3, 4 mg
Begin in evening. May need 3 times/day. No
patch form. Must take 7 d/wk.
Intuniv usually AM, once a day
child: 1.0-5.0mg
Adoles: 1.0-4mg
Adult:2.0-6mg
onset 30-45 min
duration: 4-8 hrs
Less sedating than Clonidine, but can cause
sedation, sometimes (25%) nightmares. May lower blood pressure.
Intuniv is once a day in AM, longest duration, least sedating, often smoother and is a new
brand.
Less sedating than Clonidine. Same other
benefits. Can be given 2 or 3 times/day. May need 1-2 weeks to build up.
Helps tics, hyperactivity. Does not cut appetite. Invented to treat high
blood pressure. Generic available.
Will
not help attention as much as
stimulants. Do not stop suddenly, same as Clonidine. May rarely have
unexpected heart effects.
Catapres
(clonidine)
Kapvay
(clonidine ER)
0.1 mg
0.2 mg
Patch
(TTS-1/2/3)
tablets
0.1, 0.2mg
Begin in evening due to sedation. May need
to build up to 4 times/day. Patch on skin lasts 5-7 days. Must take 7 d/wk.
Kapvay is usually AM.
May be given BID.
Adoles: 0.1-0.6mg
Patch up to TTS-3
duration: 3-5 hrs
patch 4-7 days duration
Very sedating. May lower blood pressure,
dizziness. Skin irritation common with patch.
Kapvay is similar to Intuniv.
Helps tics. Helps severe hyperactivity and
impulsivity. May need 1-2 weeks to build up. Does not cut appetite. Invented
to treat hypertension. Has been used to treat opiate and/or nicotine
withdrawal. Older, generic available.
Avoid if serious depression. Partial effect
on attention. Taper off slowly to avoid rebound hypertension or agitation.
May rarely have unexpected heart effects.

Created by Kevin Leehey, M.D., August, 2016 • www.leeheymd.com
Retrieved from www.leeheymd.com/charts/adhd_1.html